A 43-year-old man presents to emergency with a 5-day history of hematemesis and hematochezia
on a background of chronic alcoholism and hepatitis C. His skin tone is pale and he is sudoretic
(hyperhydrotic). HR is 135 bpm, RR 12, and BP 85/38 mm Hg. The liver edge is palpable 4 cm
below the right costal margin. Palmar erythema is salient. After adequate hemodynamic
resuscitation with 0.9% NaCl and packed RBCs, he undergoes emergent upper GI endoscopic
treatment. He is also administered pharmacologic therapy to directly address his presenting
pathology. Which of the following might be an effect of receiving this pharmacologic therapy?
- A) Decreased renin release
- B) Decreased glucagon release
- C) Increased blood glucose
- D) Increased thyroid-stimulating hormone release
0 voters
Treatment of acute variceal hemorrhage3
Immediate:
• Hemodynamic resuscitation (i.e., fluids, blood)
• Antibiotics
• Octreotide
Next 12-24 hours:
• Confirm diagnosis with upper endoscopy
• Perform endoscopic variceal ligation (EVL; “rubber banding”) or sclerotherapy
Somatostatin inhibits the release of glucagon. This causes decreased, not increased, blood
glucose.4, 5 Somatostatin also decreases, not increases, thyroid-stimulating hormone release.6 It has
no effect on the renin-angiotensin-aldosterone system (RAAS).7